Provider Demographics
NPI:1679668537
Name:KIERLAND FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:KIERLAND FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-788-4200
Mailing Address - Street 1:5533 E BELL RD STE 109
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1256
Mailing Address - Country:US
Mailing Address - Phone:602-788-4200
Mailing Address - Fax:602-788-4208
Practice Address - Street 1:6339 E GREENWAY RD STE 104
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6517
Practice Address - Country:US
Practice Address - Phone:480-443-7678
Practice Address - Fax:480-443-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ70181Medicare ID - Type Unspecified